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The Psychology of Addiction

Understanding the Stages of Addiction

To understand the psychology behind addiction, it is important to start with the basic of the behavior. If you understand the root causes, an addiction may be easier to overcome, treat, or sympathize with the addict’s experience.

Addiction is identified by an individual engaging in an activity or behavior that starts as pleasurable but cannot stop the behavior, even to the detriment of everyday living. This may include harm to family, work, hobbies, and other commitments. An addict may set aside their well-being and health or the well-being of their loved ones.

In many cases, the cause of the addiction or addictive behavior is some aspect of emotional stress that is deep-rooted, often subconscious, and overwhelming. A person may begin to use a substance or practice behavior that is pleasurable, but then that behavior turns into a form of self-medication against the underlying feelings or symptoms.

Substance or behavioral addiction may be a mask or distraction from this emotional stress, so stopping the behavior threatens to allow the stress or pain to reemerge.

Addiction as a Coping Mechanism

Addiction suggests that the person does not have healthy coping mechanisms to deal with stress, trauma, or pain. Unfortunately, addiction is enslavement with a powerful and overreaching influence on the brain.

Addiction causes a pattern of 3 things:

  1. Cravings for the addictive object, substance, or behavior
  2. Loss of control over the addictive behavior
  3. Continued use despite harm to oneself or loved ones

Neurologically, it is not just drugs or alcohol that can cause addiction. It can be a variety of pleasure-driven, dopamine-releasing activities including gambling, eating, sex, or shopping. Regardless of the mode or object of addiction, it manifests as a chronic disease that affects the brain structure and function.

How Addiction Changes the Brain

As addiction progresses, the brain adapts as part of what is called the pleasure principle. The pleasure principle is the concept that the brain registers all pleasure in the same way in the brain, whether from a drug, sex, food, or activity.

When the brain receives a pleasure signal, there is a release of dopamine, a neurotransmitter, to the nerve cells in the cerebral cortex. Drugs, even nicotine, cause a strong surge of dopamine within the brain.

The faster the dopamine release, the more likely it will cause addiction when addictive tendencies are present. For example, intravenous drug use administers a drug faster than taking it orally, so it provides a stronger and faster dopamine release. This explains why it is more likely to cause addiction or abuse. As that release comes faster, a habit is born to achieve the same results. Dopamine is not only a key factor in pleasure, but it also plays a role in forming memories and learning, both of which encourage drug use to become an addiction.

Another factor in the pleasure principle is glutamate, the pleasure chemical linked with survival. Addictive substances work on the same circuit as glutamate, providing an overload of pleasure and reward feelings with use. When this is the case, survival-based rewards are confused with substance use, increasing the likelihood of addiction.

As Tolerance Builds, Pleasure Rewards Decrease

Over time, the brain will seek out the substance that originally brought pleasure, but it will become less pleasurable. Although the brain is initially flooded with feel-good chemicals during use, the brain’s receptors eventually become overwhelmed, and the brain adapts. At this point, it will produce less dopamine and will eliminate the dopamine and glutamate receptors, creating less of an impact on the brain’s reward center during use.

This reduction in reward causes the person to seek out more of the substance or behavior in an attempt to achieve the desired results. This is the building of tolerance.

Once tolerance develops, compulsion takes over as the person remembers the initial pleasure and attempts to recreate it. The compulsive conditioned response is an intense craving that presents whenever the stressors arise, or the person encounters familiar environmental cues. Compulsive use trumps any regard for the welfare and stability associated with “normal” life, as the substance or addictive behavior is all the person sees.

Environmental Factors and Relapse: Recovery Is Crucial

Cravings and triggers are often associated with relapse after a period of sobriety. Being in an environment associated with the addiction, around substances themselves, or feeling emotional stress can push a person back into addiction.

To fight these risks, having a stable, sound base for recovery is critical. The fear of being found out may make a person refrain from seeking recovery, but there are options for discrete, non-reported recovery help. At Fifth Avenue Psychiatry, you have the option to receive psychotherapeutic treatment with medical approaches to recovery. When professional discretion is required, it is important to know that seeking help on your own is not reportable, and our team takes the utmost care to keep treatment private and discrete.

Fifth Avenue Psychiatry in New York is a safe option for addiction services focused on executives and professionals who need private care. Our team has your privacy in mind above all else. Dr. Glazer has been recognized as a Castle Connolly Top Doctor since 2015 and is featured in New York Magazine’s Best Doctors issue.

Samuel Glazer, MD

Samuel Glazer, MD

Samuel Glazer, MD, a psychiatrist nationally known for his work with addicted executives and professionals, began his private practice in 1998. Dr Glazer has been recognized as a Castle Connolly Top Doctor since 2015, and was recently featured in New York Magazine’s Best Doctors issue. He is a Board Certified Psychiatrist and Addiction Psychiatrist, and is a Life Fellow of the American Psychiatric Association.

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